342700471-9-26-2024-59-AS-KHOS-D9LH5C-20240930055318

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 342700471
Report Date: 09/26/2024
Date Signed: 09/26/2024 10:36:33 AM

Unfounded

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/14/2024 and conducted by Evaluator Cheyenne Ratajczak

COMPLAINT CONTROL NUMBER: 59-AS-20240814132116

FACILITY NAME:	COGIR OF STOCK RANCH		FACILITY NUMBER:	342700471
ADMINISTRATOR:	DAVID JR., RICKY		FACILITY TYPE:	740
ADDRESS:	7418 STOCK RANCH RD		TELEPHONE:	(916) 725-7418
CITY:	CITRUS HEIGHTS	STATE: CA	ZIP CODE:	95621
CAPACITY:	99	CENSUS: 76	DATE:	09/26/2024
		UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Administrator- Ricky David		TIME COMPLETED:	10:45 AM

ALLEGATION(S):

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Facility did not update Needs and Services Plans for residents

INVESTIGATION FINDINGS:

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On 09/26/24, Licensing Program Analyst (LPA) Cheyenne Ratajczak and Graham Gunby arrived at the facility unannounced to deliver findings regarding a complaint the Department received on 08/14/24. LPA met with Executive Director (ED), Ricky David and explained the purpose of the visit.

During the course of the investigation, the Department conducted interviews and obtained pertinent documents relevant to the complaint investigation.

Please continue to LIC9099C…

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Laura Munoz	TELEPHONE: (916) 263-4743
LICENSING EVALUATOR NAME: Cheyenne Ratajczak	TELEPHONE: (916) 969-7879
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 59-AS-20240814132116

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: COGIR OF STOCK RANCH	FACILITY NUMBER: 342700471
	VISIT DATE: 09/26/2024

NARRATIVE

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Allegation: Facility did not update Needs and Services Plans for residents.- Unfounded
The Department reviewed records and conducted interviews to investigate the allegation that the facility did not update Needs and Services Plans for residents.

During the course of the investigation, LPA reviewed the needs and service plans for seven (7) residents who were said to be due for a reassessment during the month of August based off the system that the facility uses. Every six (6) months the system notifies staff that a reassessment is needed. It also notifies staff at the fourteen (14) day mark for a new resident in case changes need to be made to the assessment. Six (6) of the residents were due for a reassessment due to the fact it has been six (6) months since their last one. One (1) resident was due for a reassessment because they had just moved into the facility and was at their fourteen (14) day mark.

During LPAs visit on 08/20/24 Staff #1 (S1) was in the middle of updating the seven (7) residents needs and service plan. S1 explained to LPA that at the beginning of the month they print out all needs and service plans that are due and post in caregiver office. Doing this allows all caregivers to give their input on each resident and make note of things that have changed.

Based on information obtained through interviews, the Department finds the allegation to be UNFOUNDED, meaning that the allegation was false, could not have happened and/or is without a reasonable basis.

Exit interview conducted and a copy of the report was left at the facility.

SUPERVISOR'S NAME: Laura Munoz	TELEPHONE: (916) 263-4743
LICENSING EVALUATOR NAME: Cheyenne Ratajczak	TELEPHONE: (916) 969-7879
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2024

LIC9099 (FAS) - (06/04)

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